Ask an expert - muscles and bones - arm - brachial neuralgia

3 questions

Q: I have a nerve that is irritated by a slipped disc. The surgeion won't operate and after two x ray guided injections the pain is the same with little change after 8 months. Would accupuncture help me ?

A: There is no doubt that acupuncture treatment can help with low back pain, and equally evidence that it may well be effective for sciatica-type pain, as our two factsheets demonstrate:

However, any BAcC member taking on a case like yours would probably want to know a little more about the exact nature of the problem. The fact that your surgeon will not operate could mean a number of things, and although acupuncture can be very effective at reducing pain, if there is permanent physical or structural damage, then its use would only have a temporary benefit. The fact that two specifically targetted injections have had no effect is also clinically significant. Random injections into an inflamed joint can miss the spot, but X-ray guided ones tend to be effective, even if only for a short while.

However, that said, we do come across situations where the interpretation of the pain someone experiences in Chinese medicine terms means that it may be amenable to treatment. Most people over the age of 60 have some deterioration of the limbar spine, but if they get chronic backache that is not necessarily proof of a causal connectio. Chinese medicine is based on an understanding of the body and mind as a flow of energy,called 'qi', and its flow and balance. Anything which obstructs or weakens this flow can cause pain, and there is not doubt that damage to the physical body can block qi - it's all one body, after all. The question is whether that flow can be restored in spite of the continuing presence of the physical damage.

The only way to find out whether acupuncture treatment is suitable for your specific problem, though, is to visit a BAcC member local to you to arrange a brief face to face assessment. Most members are happy to give up a small amount of time without charge to offer prospective patients a more informed view of whether treatment is worthwhile or whether other forms of intervention may be more appropriate.

Q. My Father has a bulging disc in his neck which is pushing against his nerve, which in turn causes him pain down his shoulder and arm when the weather is cold. It's caused his arm to be extremely weak.

Tests have proven nothing wrong with his nerves but its a few discs which are pushing against the nerve causing the problem. Doctors have suggested surgery to replace the discs.

I was wondering if Acupunture is a feasible alternative to surgery? Can you please advise?

A. This is a very difficult question to answer. Generally speaking, when there is a physical change in the structure of the body, it would be foolish to suggest without qualification that acupuncture can correct it. The neck, in particular, is an area where structural changes through wear and tear as someone gets older are very difficult to treat. That said, acupuncture may be able to reduce to an extent any inflammation which is associated with the bulging disc.

In the case of sciatica, for example, which is sometimes caused by a similar problem in the lower spine, there is some evidence that acupuncture may reduce inflammation, as we point out in our fact sheet here

However, it is quite likely, if the doctors are proposing surgery, that things have gone a bit further, and the structural changes may well continue to cause inflammation, even if acupuncture treatment provided some relief in the short term. It would probably not be wise, therefore, to consider acupuncture as an alternative to surgery.

Chinese medicine treats the person, not the disease, however, and regards each person's patterns of energy as unique and different. There may be some merit in seeking advice from one of our members tocal to you who can perhaps see your father and assess whether in his case there is greater reason to feel that acupuncture may provide positive help.

A great deal depends on how the problem is being generated. It usually manifests in a pinching of one of the nerve roots in the neck, and if the cause is physical and of this nature, then acupuncture will have little long term effect, although it may be of value in bringing some form of temporary relief. If the pain is not arising as a result of pressure at the nerve root, there may be more hope

One of the strengths of acupuncture and Chinese medicine is the different understanding of the physiology and pathology of the body. This often allows it to make sense of a symptom or a group of symptoms in ways which are different from western medicine, because whatever system of medicine one employs, the patient's account of what they feel and the visible signs are the same. Chinese medicine has developed over 2000 years with a system of its own for classifying pain and discomfort by location, strength, heat or cold nature, how it feels - sharp, dull, etc, and has a number of ways of making sense of symptoms like yours which may help to reduce the level fo discomfort you are feeling.

The best course of action is to see if one of our members local to you is happy to spare you a little time without charge to assess briefly whether your specific problem is one which they feel they may be able to help.

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